HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 11 P��•1
Date: �• �� ` Permit Number: /5-t/5— 0_&D4
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er., R EC E I V E
Building Permit Application MAY 2 1 2015
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial X Residential
PERMIT APPLICATION FOR: Window/door
RROPOSED-IM'FROVEM,ENTLOCATION
Address: 10410 S. OCEAN DRIVE, JENSEN BEACH, FL 34957
Legal Description:
Property Tax ID#: 451151400000009 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION.`OF WORK
THIS IS A LABOR ONLY PERMIT APPLICATION AS CONDO ASSOCIATION IS PROVIDING DOORS. THE FOLLOWING DOORS
WILL BE REPLACED AT UNITS: 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009 AND 10TH FLOOR STORAGE ROOM
DOOR
CONSTR'UCT10'N INFORMATION
AdclF,
itiona wor to (e ne orme un er t is permit—check a appy:
HVAC L_J Gas Tank F]Gas Piping _Shutters ✓�Windows/Doors
Electric ElPlumbing ❑Sprinklers E Generator 1:1 Roof
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ 7000.00 Utilities: Sewer Septic Building Height:
OWUER/LESSEE CONTRACTOR;,
Name HUTCHINSON ISLAND CONDO ASSN Name: MICHAEL ROBERTS
Address:10410 S. OCEAN DR. Company: SPECIAL FORCES RESTORATION AND CC
City: JENSEN BEACH State:FL Address: 1235 NE DIXIE HWY
Zip Code: 34957 Fax: City: JENSEN BEACH State:FL
Phone No. ��, ��� CL3 07 Zip Code: 34957 Fax:
E-Mail: Phone No. 772-334-2990
Fill in fee simple Title Holder on next page(if different E-Mail: TAMMY@SPECIALFORCESUS.COM
from the Owner listed above) State or County License: CGC 059083
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTR,UCTIQN LIEN LAW INFORMATION
r c
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: JOHN BREITENBACH Name:
Address:4853 SE PILOT WAY Address:
City: STUART State: FL City: State:
Zip: 34997 Phone: 772-834-4743 Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie County makes no representation that is granting a permit will authorize thepermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit,I do hereby agree that I will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St.Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review:room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing,consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
s
_Sign re of Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTYOF SI- (/G(E COUNTYOF ST UIC/O
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this �ay of 20 Eby this 011i day of20by
MICHAEL ROBLRTS MICHAEL ROBERTS
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary P�ubli -�State of Florida). (Signature of Notary Public- to of Florida)
Personally Known '' OR Produced Identification Personally Known L- OR Produced Identification
Type of Identific T$Wf1tWducep�MERALOFLAND Type of Identification rPIP, d
* * MY COMMISSION#FF 014554 ? '..�.'��� MY COMMISSION ii� �54
Commission No. EXPIRES:May5( I) Commission No. * * }r
OF FLOP\ Bonded Thru Budget Notary Services ,�� IRES:May ,
""tOF iO Bonded Thru Budget Notary Services
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
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